Extended report: nail disease in psoriatic arthritis—clinically important, potentially treatable and often overlooked

Objectives. To examine the relationship between the severity of nail disease and characteristics of psoriatic arthritis (PsA). We also wished to assess the clinical management of nail disease in patients with PsA. Methods. We studied 69 patients with PsA at two visits. On the first visit, a rheumato...

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Published in:	Rheumatology (Oxford, England) England), 2004-06, Vol.43 (6), p.790-794
Main Authors:	Williamson, L., Dalbeth, N., Dockerty, J. L., Gee, B. C., Weatherall, R., Wordsworth, B. P.
Format:	Article
Language:	eng
Subjects:	Adolescent Adult Aged Antirheumatic Agents - therapeutic use Anxiety - etiology Arthritis, Psoriatic - complications Arthritis, Psoriatic - drug therapy Biological and medical sciences Child Child, Preschool Depression - etiology Dermatology Disease Progression Diseases of the osteoarticular system Humans Inflammatory joint diseases Medical sciences Middle Aged Nail disease Nail Diseases - drug therapy Nail Diseases - etiology Nail Diseases - psychology Psoriasis - drug therapy Psoriasis - pathology Psoriasis. Parapsoriasis. Lichen Psoriatic arthritis Regression Analysis Severity of Illness Index
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Summary:	Objectives. To examine the relationship between the severity of nail disease and characteristics of psoriatic arthritis (PsA). We also wished to assess the clinical management of nail disease in patients with PsA. Methods. We studied 69 patients with PsA at two visits. On the first visit, a rheumatology assessment of joint, skin and nail disease was made. On the second visit, a detailed dermatology assessment of skin and nails was made. Nail disease was analysed using a 20-nail psoriasis nail severity score (PNSS). Results..There were 57 (83%) patients with clinical evidence of psoriatic nail disease. Although 66 (96%) patients had been treated for skin disease, only one (1%) had received any treatment for nail disease. Severe nail disease measured by the PNSS correlated with severe skin psoriasis as indicated by the percentage of body surface area affected by psoriasis (r = 0.34, P = 0.004) and physician global assessment of psoriasis (r = 0.45, P
ISSN:	1462-0324 1462-0332